THINKING AND WORKINGCONTEXTUALLY:

TOWARD A PHILOSOPHY OFPSYCHOANALYTIC PRACTICE

Robert D. Stolorow, Ph.D.

Donna M. Orange, Ph.D., Psy.D.

George E. Atwood, Ph.D.

The development of what we call the intersubjective perspective in psychoanalysis has had five movements, each punctuated by a book. In the first, Faces in a Cloud, having demonstrated through psychobiographical studies that psychoanalytic metapsychologies derive profoundly from the personal, subjective worlds of their creators, we concluded that what psychoanalysis needs is a theory of subjectivity itself, a unifying framework that can account not only for the phenomena that other theories address but also for the theories themselves. In the second, Structures of Subjectivity, we introduced the concept of an intersubjective field--the system formed by differently organized, reciprocally interacting subjective worlds--as the fundamental theoretical construct for this framework. In the third, Psychoanalytic Treatment, we applied the intersubjectivity principle to an array of important clinical issues, such as analysis of transference and resistance, therapeutic action, and treatment of borderline and psychotic states. In the fourth, Contexts of Being, we circled back to four foundational pillars of psychoanalytic theory—the unconscious, mind-body relations, trauma, and fantasy—and resituated them from an intersubjective perspective. Picking up on the title of this last book, our fifth movement, Working Intersubjectively, is devoted to a broad-based philosophy of psychoanalytic practice that we refer to as contextualism.

What does it mean to think and work contextually? The intersubjective perspective does not eliminate psychoanalysis’s traditional focus on the intrapsychic. Rather, it contextualizes the intrapsychic. The problem with classical theory was not its focus on the intrapsychic, but its inability to recognize that the intrapsychic world, as it forms and evolves within a nexus of living systems, is profoundly context-dependent. In Contexts of Being we addressed this issue as follows:

The concept of an intersubjective system brings to focus both the individual’s world of inner experience and its embeddedness with other such worlds in a continual flow of reciprocal mutual influence. In this vision, the gap between the intrapsychic and interpersonal realms is closed, and, indeed, the old dichotomy between them is rendered obsolete [p. 18].

Pushing this line of argument even further, we contend that from an intersubjective systems perspective, the very distinction between one-person and two-person psychologies --at the heart of much current debate in psychoanalysis—-is obsolete, because the individual and his or her intrapsychic world are included as a subsystem within the more encompassing relational or intersubjective suprasystem. The very idea of a two-person psychology continues to embody an isolated-mind philosophy in that two separated minds, two "windowless monads" (Leibniz), are seen to bump into each other. Such a conception fails to recognize the constitutive role of relatedness in the making of all experience. We ought to speak instead of a contextual psychology. One of us (Stolorow) has sometimes quipped that perhaps intersubjectivity theory is a no-person psychology, concerned as it is with how worlds of inner experience and intersubjective fields mutually constitute one another.

Intersubjectivity theory differs from other psychoanalytic theories in that it does not posit particular psychological contents that are presumed to be universally salient in personality development and in pathogenesis. It is a process theory offering broad methodological and epistemological principles for investigating and comprehending the intersubjective contexts in which psychological phenomena, including psychoanalytic theories, arise. It also provides a framework for integrating different psychoanalytic theories by contextualizing them. From an intersubjective perspective, the content themes of various metapsychological doctrines--Freud’s Oedipus complex, Klein’s paranoid/schizoid and depressive positions, Kohut’s mirroring, idealizing, and twinship longings, and the like --can be deabsolutized, deuniversalized, and recognized as powerful metaphors and imagery that can become salient in the subjective worlds of some people under particular intersubjective circumstances. Personal experience is pictured here as fluid, multidimensional, and exquisitely context-sensitive, with multiple dimensions of experience oscillating between foreground and background, between figure and ground, within an ongoing intersubjective system of reciprocal mutual influence.

In the psychoanalytic setting, thinking and working contextually means recognizing that analyst and patient form an indissoluble psychological system, and that neither can, without violence to the integrity of the analytic experience, be studied alone. The organizing activities of both participants in any psychoanalytic process are crucial to understanding the impasses and meanings that develop in a specific intersubjective field. When the process gets stuck, we do not think "the patient is resisting;" instead, we wonder how this logjam was coconstructed. We ask not only about the patient’s history and organizing emotional convictions, but also about our own, as well as about what theoretical commitments might be trapping us in what Wittgenstein called "aspect-blindness." Aspect-blindness results from an inability to shift perspectives, to expand horizons, or to decenter. Thus, a contextual focus includes the interacting subjective worlds and organizing activities of both patient and analyst, including the analyst’s theories and the cultural worlds of both participants.

In a further development of our philosophy of practice, we are suggesting that dynamic or nonlinear systems theory, because it accounts for the "messy, fluid, context-sensitive" nature of developmental processes (Thelen and Smith, 1994, p. xvi), is exceptionally well suited to serve as a source of guiding metaphors for a psychoanalytic contextualism. A dynamic systems account of a developmental process, whether occurring during childhood or in the psychoanalytic situation, rejects teleological conceptions of preordained end-states and preprogrammed epigenetic schemas. Instead, structure or pattern is seen to be emergent from "the self-organizing processes of continuously active living systems" (p. 44). Emergent structure formation within a dynamic system develops from the intercoordination or cooperative interaction of its elements or subsystems as they coalesce into a self-organized pattern. From this perspective, for example, intractable repetitive transferences and resistances seen clinically can be grasped as rigidly stable states of the patient-analyst system in which the analyst’s stance has become tightly coordinated with the patient’s grim expectations and fears of retraumatization. Examples in our work of clinical phenomena viewed from a systems perspective include a vision of psychopathological states, of multiple dimensions of transference, and of the very boundary between conscious and unconscious, all as fluidly shifting properties of ongoing dynamic, dyadic, intersubjective systems.

The intersubjective perspective, however, is not a clinical theory in the sense of a set of prescriptions or rules of technique. Indeed, we criticize the very concept of technique in psychoanalysis as relying on an assumption that one isolated mind, the analyst, is supposed to do something to another isolated mind, the patient. Technique belongs to the realm of things and of generality, mechanization, and routinization, not to mention compliance and accommodation. The intersubjective field, on the contrary, is the realm of practice, the area of understanding, the uniquely patterned interplay of particular subjectivities. In practice, we are defining not technique, but a sensibility that informs our thinking and our work, a sensibility that can be described, in part, in terms of attitudes.

A contextualist view leads inevitably to a self-reflexive attitude that remains perpetually open to new dimensions of action and experience. Fallibilism (Orange, 1995) characterizes both the thought and practice of a contextualist. This means that we recognize that our present understanding of anything or anyone is only a perspective within a horizon inevitably limited by the historicity of our own organized and organizing experience. In practice, a contextualist holds lightly not only theory, but any particular view of meaning in the patient’s experience or in the cocreated experience in the intersubjective field of treatment. This fallibilistic attitude keeps us flexible and open to multiple, emerging, and expanding horizons of meaning. It also ensures that our theoretical ideas can continue to evolve toward an ever-widening and more encompassing viewpoint.